Tuesday, May 6, 2014

Thursday, May 1, 2014

Which Came First - the Depression or the Insomnia?

insomnia, sleep, depression, healthy, therapy, disorder
The age-old question: Which came first - the depression or the egg? Or the chicken? No, wait - the insomnia! Do you find that you can't sleep normally at night because of depression? One thing is for sure - depression adversely effects sleep. But does one cause the other? Up until recently, no one would deny that depression causes irregular sleep habits. That is still true but recent studies have shown the opposite to be true as well. Insomnia, specifically, can lead to depression.

     Of all the symptoms associated with depression, insomnia has been a commonplace cohort. Insomnia, the inability to go to sleep or stay asleep long enough for at least 3-4 weeks, produces fatigue (big surprise, right?), irritability, memory problems, reduced concentration, weight gain, increased risk of heart disease and lowers the immunity system. The majority of physicians have echoed the sentiment that it would be cured as the depression was successfully treated (Carey, 2013). But, is it a one-way street? It's more likely that they play off of each other. Along with the traditional effects, evidence suggests that people with insomnia have a ten-fold risk of developing depression compared with those who sleep well (SleepFoundation.org).
     Historically, this relationship was thought to be clear - depression causes sleep disorders. Therefore, the consensus was treat the cause, cure the symptom. That idea has begun to shift. Rachel Manber, a professor in the psychiatry and behavioral sciences department at Stanford, declares, “but we now know that’s not the case. The relationship is bidirectional — that insomnia can precede the depression.” (Carey, 2013) One poll, focusing on adolescents aged 11 to 17, found that of those reporting unhappy moods, 73% were not sleeping enough at night (SleepFoundation.org). Psych Central reports that two recent studies verify the link between sleep duration and depression (Wood, 2014). One, measuring sleep duration among twins, reported double the rate of depressive symptoms for those that slept 5 hours a night compared to those that slept 7-9 hours per night.
     Based on these findings, some changes in treatment and prevention should be considered. Some scientists claim that curing insomnia in people with depression could double their chance of a full recovery. How do you treat insomnia? Adding more prescriptions doesn't seem to be the answer. SSRIs, which often help improve mood, can cause or worsen insomnia. Positive results have been seen by using talk therapy and cognitive behavior therapy instead of drugs. "Optimizing sleep may be one way to maximize the effectiveness of treatments for depression, such as psychotherapy,” said Dr. Watson (Wood, 2014).
     The first step to getting help in this area is to keep a sleep diary for at least two weeks straight. Each day record how many hours you slept along with your mood the next day. You can take this to your doctor or therapist for help with treatment. Recommendations to treat insomnia can include:
  • Keep a regular sleep/wake schedule
  • Get into bright light soon after waking in the morning
  • Get some form of exercise every day
  • Avoid afternoon naps if you have nighttime insomnia
  • Limit caffeine and alcohol, especially before bed time
  • Avoid eating, reading or watching TV in bed
If you suffer from insomnia along with depression, be sure to discuss these recent studies with your doctor. As you begin to implement the strategies listed above, keep journaling your daily mood, noting changes in well-being as well as sleep quality. Over time, you should begin to see the positive changes you desire with sleep problems becoming the exception, not the norm. Nighty-night!

In peace I will lie down and sleep, for you alone, O LORD, will keep me safe. Psalm 4:8